Tshimungu K, Okenge L N, Mukeba J N, de Mol P
Laboratoire de microbiologie médicale, CHU Sart-Tilman, université de Liège, B23, 4000 Liège, Belgique.
Med Mal Infect. 2010 Aug;40(8):462-7. doi: 10.1016/j.medmal.2009.12.007. Epub 2010 Jan 15.
The incidence of human African trypanosomiasis (HAT) or sleeping sickness in Kinshasa has been increasing since 1996. The objectives of this study were first to identify the optimal levels of knowledge, and then to determine the risk factors for HAT in the city of Kinshasa.
This case/control study was based on a structured questionnaire. Case-patients were detected and treated between 1 January 2004 and 31 December 2005. Each case-patient was paired with two seronegative controls of the same age and sex, living in the same type of environment. The study included 437 case-patients and 874 controls.
The optimal level of knowledge defined by the list of elementary notions related to HAT was 44% for the case-patients and 37.0% for controls (p<0.0001). The majority of individuals (86.7%) was favorable to passive screening. The patients living in peripheral areas were more at risk than other groups, in rural areas (odds-ratio 12.1; 95% IC: 5.7-21.7), and remote areas (odds-ratio 8.9; 9% IC: 2.1-38.8). A family history of HAT (odds-ratio 12.9; 95% IC: 7.9-20.8), ignoring the transmission route (odds-ratio 11.2; 95% IC: 5.8-21.7), and the water supply in natural points (odds-ratio 6.9; 95% IC: 2.8-17.2) were also risk factors.
The results identified avoidable factors, which could be taken into account, to decrease the incidence of new contamination, the morbidity, and mortality of HAT.
自1996年以来，金沙萨的人类非洲锥虫病（HAT）即昏睡病发病率一直在上升。本研究的目的首先是确定最佳知识水平，然后确定金沙萨市HAT的危险因素。
本病例对照研究基于一份结构化问卷。在2004年1月1日至2005年12月31日期间对病例患者进行检测和治疗。每个病例患者与两名年龄和性别相同、生活在相同环境类型的血清阴性对照配对。该研究包括437例病例患者和874名对照。
根据与HAT相关的基本概念清单确定的最佳知识水平，病例患者为44%，对照为37.0%（p<0.0001）。大多数人（86.7%）赞成被动筛查。居住在周边地区的患者比其他群体面临更高风险，在农村地区（优势比12.1；95%置信区间：5.7-21.7）和偏远地区（优势比8.9；9%置信区间：2.1-38.8）。HAT家族史（优势比12.9；95%置信区间：7.9-20.8）、忽视传播途径（优势比11.2；95%置信区间：5.8-21.7）以及天然水源供水（优势比6.9；95%置信区间：2.8-17.2）也是危险因素。
研究结果确定了可避免的因素，这些因素可被考虑在内，以降低新感染的发生率、HAT的发病率和死亡率。
